The impact of tumor size and histology on local control when utilizing high-dose-rate interstitial brachytherapy for gynecologic malignancies.

Autor: Schiff JP; Department of Radiation Oncology, Washington University School of Medicine, 4921 Parkview Place, Campus Box 8224, St. Louis, MO 63110, USA. Electronic address: j.p.schiff@wustl.edu., Mahmood M; Department of Radiation Oncology, Washington University School of Medicine, 4921 Parkview Place, Campus Box 8224, St. Louis, MO 63110, USA. Electronic address: m.mahmood@wustl.edu., Huang Y; Department of Radiation Oncology, Washington University School of Medicine, 4921 Parkview Place, Campus Box 8224, St. Louis, MO 63110, USA. Electronic address: huangyi1@wustl.edu., Powell MA; Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, Washington University School of Medicine, 4901 Forest Park Ave Suite 710, St. Louis, MO 63108, USA. Electronic address: mpowell@wustl.edu., Mutch D; Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, Washington University School of Medicine, 4901 Forest Park Ave Suite 710, St. Louis, MO 63108, USA. Electronic address: mutchd@wustl.edu., Dyk PT; Department of Radiation Oncology, Missouri Baptist Medical Center, 3015 N Ballas Rd, St. Louis, MO 63131, USA. Electronic address: pawel.dyk@bjc.org., Lin AJ; Reno Cyberknife, Saint Mary's Center for Cancer, 645 N Arlington Ave #120, Reno, NV 89503, USA; Gene Upshaw Memorial Tahoe Forest Cancer Center, 10121 Pine Ave, Truckee, CA 96161, USA., Schwarz JK; Department of Radiation Oncology, Washington University School of Medicine, 4921 Parkview Place, Campus Box 8224, St. Louis, MO 63110, USA. Electronic address: jschwarz@wustl.edu., Markovina ST; Department of Radiation Oncology, Washington University School of Medicine, 4921 Parkview Place, Campus Box 8224, St. Louis, MO 63110, USA. Electronic address: smarkovina@wustl.edu., Grigsby PW; Department of Radiation Oncology, Washington University School of Medicine, 4921 Parkview Place, Campus Box 8224, St. Louis, MO 63110, USA. Electronic address: pgrigsby@wustl.edu.
Jazyk: angličtina
Zdroj: Gynecologic oncology [Gynecol Oncol] 2022 Jun; Vol. 165 (3), pp. 486-492. Date of Electronic Publication: 2022 Apr 01.
DOI: 10.1016/j.ygyno.2022.03.017
Abstrakt: Objective: To report long-term results of an outpatient template-based high-dose-rate interstitial brachytherapy (HDR ISBT) program for the treatment of gynecologic malignancies.
Methods: Patients treated between 2006 and 2020 at an academic hospital with outpatient template based HDR ISBT without spinal or general anesthesia were reviewed. Patients who had previously received HDR ISBT were excluded. Baseline patient, tumor, and treatment characteristics, such as tumor size, histology, and/or total EQD2 including prior external beam radiation therapy (EBRT) were recorded. Local control and overall survival were estimated using the Kaplan-Meier method, and factors associated with local control and overall survival were evaluated using Cox regression analyses.
Results: 150 patients received HDR ISBT for a gynecologic tumor and the median follow-up time was 2.98 years (0.89-4.82). Of those, 74/150 (49%) were treated definitively, 69/150 (46%) were treated for tumor recurrence/persistence, and 7/150 (5%) were treated for durable palliation. Median tumor size was 3.00 cm (1.50-4.00). 124/150 (83%) patients received EBRT prior to HDR ISBT. Median HDR ISBT dose was 18 Gy delivered in eight fractions. Local control was 71% (64%-79%), 58% (50%-68%), and 57% (48%-67%) at one, three, and five years, respectively. On multivariate analysis, non-endometrial adenocarcinoma histology (HR = 2.423, 95% CI = 1.011-5.808, p = 0.047) and tumor size ≥ 3 cm (HR = 2.903, 95% CI 1.053-3.441, p = 0.033) were associated with lower local control.
Conclusions: The majority of patients who received outpatient-based twice daily HDR ISBT had long-term local control. Larger tumor size and non-endometrial adenocarcinoma histology were detrimental to local control.
Competing Interests: Declaration of Competing Interest We have no conflicts of interest to disclose which specifically pertain to the creation of this manuscript. Conflicts of interest unrelated to this manuscript are summarized in the supplied ICJME forms.
(Copyright © 2022 Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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